A new infant hybrid respiratory simulator: preliminary evaluation based on clinical data

• Published in: Medical & biological engineering & computing Vol. 55; no. 11; pp. 1937 - 1948
• Main Authors: Stankiewicz, Barbara, Pałko, Krzysztof J., Darowski, Marek, Zieliński, Krzysztof, Kozarski, Maciej
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2017; Springer Nature B.V
• Subjects: Baby foods; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Birth; Birth weight; Breathing; Bronchopulmonary Dysplasia - physiopathology; Computer Applications; Computer simulation; Correlation coefficients; Dysplasia; Evaluation; Human Physiology; Humans; Imaging; Infant; Infant, Newborn; Infant, Premature - physiology; Infants; Low birth weight; Lung - physiology; Lungs; Mathematical models; Mechanical ventilation; Mechanics (physics); Newborn babies; Original Article; Premature babies; Pressure; Radiology; Respiration; Respiration, Artificial - methods; Respiratory Mechanics - physiology; Respiratory system; Respiratory tract; Ventilation; Ventilators; Infant; Decision support techniques; Respiratory system; Mechanical ventilation
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-017-1635-9

A new hybrid (numerical–physical) simulator of the respiratory system, designed to simulate spontaneous and artificial/assisted ventilation of preterm and full-term infants underwent preliminary evaluation. A numerical, seven-compartmental model of the respiratory system mechanics allows the operator to simulate global and peripheral obstruction and restriction of the lungs. The physical part of the simulator is a piston-based construction of impedance transformer. LabVIEW real-time software coordinates the work of both parts of the simulator and its interaction with a ventilator. Using clinical data, five groups of “artificial infants” were examined: healthy full-term infants, very low-birth-weight preterm infants successfully (VLBW) and unsuccessfully extubated (VLBWun) and extremely low-birth-weight preterm infants without (ELBW) and with bronchopulmonary dysplasia (ELBW_BPD). Pressure-controlled ventilation was simulated to measure peak inspiratory pressure, mean airway pressure, total (patient + endotracheal tube) airway resistance ( R ), total dynamic compliance of the respiratory system ( C ), and total work of breathing by the ventilator (WOB). The differences between simulation and clinical parameters were not significant. High correlation coefficients between both types of data were obtained for R , C , and WOB (γ R  = 0.99, P  < 0.0005; γ C  = 0.85, P  < 0.005; γ WOB  = 0.96, P  < 0.05, respectively). Thus, the simulator accurately reproduces infant respiratory system mechanics.